More Smiles Dental Spa Dentistry Blog | James A. Moreau, Jr., D.D.S.

Tuesday, June 17, 2008

Silver Mercury Dental Fillings Scrutinized by FDA

After years and years of inaction by the Food and Drug Administration, an anti-amalgam consumer group, Moms Against Mercury has filed a class action suit against the FDA to force it to make a ruling regarding the safety, or lack thereof, of silver amalgam fillings that contain mercury.

Mercury in silver fillings has been a controversial issue as some consumers and patients assert that mercury in the mouth can have neurotoxic effects on humans and should be banned in dentistry. On the other hand, the American Dental Association and organized dentistry in general present that there is absolutely no scientific evidence to prove a connection between silver mercury fillings and health problems. This is true...but there are also no studies that have been able to prove it perfectly safe either.

Last week, the FDA responded to the lawsuit by issuing a warning that silver amalgam fillings may pose a risk to children and developing fetuses. On its web site, the FDA has dropped much of its reassuring language about dental amalgam. And it's added what amounts to a warning: "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses." It also stated that pregnant women and other mercury-sensitive people should discuss other options with their dentist. Many people believe this is the beginning of the end of silver fillings.

The FDA has also agreed to rule within one year on exactly how dental mercury fillings should be regulated and what kind of warnings patients should receive from their dentists. During this year, the FDA is open to comments from the public regarding the issue.

The lawsuit contends that while the FDA has taken a stand against other uses of mercury because of the danger it poses, it has dragged its feet for years in deciding to take a position as to the use of mercury in dentistry.

While modern dentistry provides excellent alternatives to amalgam, orrganized dentistry has pushed to continue mercury fillings as a less expensive option to ensure that people can afford to have the dental care they need. The alternative, tooth-colored composite fillings that do not contain mercury, are harder for a dentist to do, particularly on back teeth where it is more difficult to keep the tooth dry during the procedure. Eliminating amalgam as an option would require dentist who wish to continue practicing to purchase the composite materials, instruments and get the proper training on how to place them successfully. It's estimated that about 85% of dental offices in the U.S. still offer silver fillings.

At MoreSMILES, we left silver mercury fillings behind in 1996 and when we moved into our new facility in 2000, we esablished a mercury ( and latex ) free environment.

Again, while there are no studies to substantiate claims that mercury fillings have neurotoxic effects, there are also no studies to prove that they don't. If we can't put mercury in a river, why should it be legal to insert it in the human mouth ( even in the form of an unstable mixture - amalgam is 50% mercury ) ? By the way, in "Alice in Wonderland", mercury is what made the Mad Hatter mad. It was a common occupational injury of hatters since they used it to stiffen felt when shaping brims of hats.

With beautiful resin materials available since the '80s that blend aesthetically with natural tooth surface, there is really no reason to continue using, at least in our opinion, unsightly silver material that may or may not be harmful to the health of our patients and can cause teeth to crack as it expands and contracts with temperature changes inside the mouth.

Dr. Moreau used to joke that he never once had a patient thank him for putting a big silver filling in a tooth. To the contrary, natural-looking tooth-colored restorations done expertly with composite material have drawn compliments from our grateful patients.

We do not encourage patients who have old silver fillings in their mouth to aggressively have them replaced with composite filling material, but we have occasionally done this for patients who did have health concerns and wished to eliminate mercury fillings as a possible culprit.

IMHO, there is no really good reason for continuing to use silver mercury fillings.


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posted by MoreSmiles at 9:06 PM


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